Tribal and legal litigation in obstetrics in Basrah city; southern of Iraq

Litigation in obstetric practice has been increased worldwide.So many obstetricians adapt a defensive practice which may lead negative effect on care provided or even quitting fields of obstetrics to specialty less susceptible to litigation.To identify the commonest causes of legal and tribal litigation in the field of obstetric in our locality in order to create strategies to decrease their incidence and thus improve the quality of health delivered to pregnant women.This is a retrospective observational study held in Basrah/Iraq covers the period from 2017-2022.Information about medical litigation was collected from obstetricians and Basrah Health Directorate, including whether or not there was faults in medical care according to the decision of professional investigative committee.Non-standard medical care was found in 29.4% of litigations.11.8% of litigations were tribal and 25% were both legal and tribal.The main cause of litigation was maternal death (42.6%),Followed by Stillbirth (13.2%).caesarean section complications (10.3%).early neonatal death (8.8%.),andhysterectomy (7.4%) .Maternal death (mainly due to postpartum hemorrhage) and stillbirth are the commonest causes of litigation in obstetrics.One third of litigation was associated with negligence or misjudgment in medical care.